October 7, 2022

Dear Interested Readers,

 

Perilously Uncertain Times 

 

I am not a good fit for my septuagenarian demographic. I don’t watch Fox News. I do on rare occasions watch a football game on Fox, but even that’s getting rarer and rarer since I am losing interest in the game. I have also given up on basketball, and since the Red Sox have fallen into last place I’ve given up on baseball as well. I don’t need to give up hockey because I have never watched it. I grew up where the only ice was in tea or an ice cream churn. 

 

I hear that GenXers, Millennials, and GenZers get their news from social media, but not me. I grew up depending on Walter Cronkite, Huntley and Brinkley, and John Chancellor to give me a preview of what I would eventually read in my local newspaper, Time magazine, or The New Yorker.  These days, I mostly depend on CBS, ABC, PBS, NPR, and sometimes CNN to augment what I read in The New York Times, The Washington Post, The New Yorker, and The Atlantic plus what I hear on podcasts about the state of the world. The Globe and The Valley News keep me abreast of local issues. I have no complaints against NBC, but they usually have little to add after I have heard/watched/read all the other sources of information and with the exception of NBC’s “Meet The Press,” ABC and CBS are enough for me.   

 

The price I pay for listening to the news on television is tolerating all the commercials for drugs. I can remember when we had cigarette commercials, but back then there were no commercials for medications that might improve your asthma, arthritis, COPD, bowel symptoms, psoriasis, eczema, depression, fibroids, incontinence, or diabetes that suggested that you should discuss getting a prescription with your doctor. One of the few things that I found onerous in practice was the time it took to explain to a concerned and insistent patient just why what they had seen on a drug ad did not fit their condition. Those extended conversations would often put me behind and the time spent would snowball into a disaster because I would need to spend several minutes with every subsequent patient that followed apologizing for the wait they had endured because I was “behind.”

 

I said that the worst part of the evening news is usually the drug ads. I said usually because what is worse than drug ads are the political ads that displace them during the run-up to elections. I am offended by the tone and the blatant misinformation in many political ads. I can’t imagine who might be moved or informed by what I see. I am not even sure that I believe all that I hear or see coming from the candidates that I support and who will eventually get my vote. Old men grumble.

 

What really troubles me is that these ads seem to contribute very little clarity to what will be very important in this election that will have a huge impact on the future of healthcare as well as the economic future of the majority of Americans. Is it true that the people who put together the ads don’t believe most of us can understand the moment and will swallow their lies? Do they believe that we will accept that their opponent is as stupid, self-serving, or as corrupt as their ad suggests? Is every Democratic member of Congress a puppet of Nancy Pelosi and Joe Biden? There was a time when the usual political rhetoric was about the merits of a candidate and their ideas about how to solve problems. Now it seems that most ads are about the damage to the country that their opponent will cause. 

 

I accept that many voters do not understand that we are not a pure democracy. We are also not a dictatorship, yet. We do not have an imperial president who is empowered to do anything he wants although many ads suggest that President Biden has within his power the ability to dispose of inflation with an executive decree which for some reason he refuses to do. The ads usually imply that as a member of Congress, the Republican running for office will be able to do what the president refuses to do. Really? What’s the plan?

 

Our Consitution and the rules of the Senate more than protect the rights of minorities; they create the possibility for mendacious politicians to control the executive, legislative, and judicial branches of government with the support of an organized and strategically deployed minority that often gains influence by being elected to represent a less populated area. It does seem strange that the vote of a senator from my state of 1.3 million people or from Wyoming with a population of more prairie dogs than people (about 680,000) has the same weight as the vote of a senator from California which has a population of over 40 million. 

 

The status quo and vested interests of a well-funded minority are protected, like the right to own an AR-15, by rules that were made 233 years ago. Those rules that advantage small states and make it possible for a minority to block progress or elect a president are very hard to change now. Even stranger is the fact that it is possible to easily convince many people to vote against their own best economic interests to preserve their perceived cultural and ethnic advantages. Those “rules” distress me for many reasons, not the least of which is that I believe that they are a major impediment to protecting the health of the nation and improving the social determinants of health for millions of Americans. Some political scientists say that when our “democracy” worked better it was because an imperfect Constitution that was full of questionable compromises from an age long passed was augmented by unwritten “norms” and a shared sense of what is “fair” that has been lost over the last thirty years. Thank you, Newt Gingrich.

 

I don’t know if the commentary above is completely true. I am sure that the realities of our political divisions and dysfunctional system are even more complex than what I have mentioned. What I do believe is true is that a combination of internal and external factors make this a very uncertain moment in time. As a voter, I wish that the Democrats were better able to present their accomplishments over the last two years. I wish that the Democrats could effectively present the reality of inflation and what they are trying to do to mitigate its impact in the context of the pandemic, global warming, the war in Ukraine, decades of errors by both parties in trade policy, decades of a failure to invest in individuals and infrastructure, and a lack of a consensus immigration policy as some of the reasons for the current state of disarray which is a worldwide problem. Because of our own energy sources, inflation is much worse in Europe than it is here. A gallon of gas in Germany currently costs $7.12. A gallon of gas in Canada is currently going for $5.26. I paid $3.29 when I filled up earlier this week using my “loyalty card.” Without that discount, the price would have been $3.39 which is close to what I would have paid if I lived in Putin’s Russia where the current price is $3.32. 

 

It is likely that in the next few days the price will climb because OPEC and the Russians agreed to reduce oil production by 2 million barrels a day. When the price goes up I am sure that we see ads that suggest that somehow it is part of some diabolical plan of Joe Biden or evidence that Joe and Nancy are part of some worldwide cabal to create pain and suffering for the good people of New Hampshire who love freedom and low taxes.

 

We live in a very complex world where an increasing number of people embrace conspiracy theories that make them feel better and seem more logical than facts. When facts don’t make a difference or are ignored, it is likely that anger and outrage make more sense than the harder work of collaboratively solving complex problems, especially when the solution may require personal sacrifice now and investment today for a more stable world tomorrow. 

 

Since the Democrats are inept at presenting a true picture of the benefits they have achieved and can’t sell their logical plan for the future in a complex world where we don’t control everything, I wish Republicans would make an effort to put forth a plausible plan that would improve the economy, reduce inequality, and protect the health of the nation. I wish they would apply as much energy to preserving life by advocating for better gun policies as they have exerted in their effort to protect the unborn with their attacks on the reproductive rights of women. I am not holding my breath on any of these wishes since it seems that the MAGA world has only one answer that fits all problems which is less government with lower taxes.

 

I wish that I was confident that wisdom and not negative rhetoric, barriers to voting, and gerrymandered congressional districts will determine the outcome of the midterm elections. I hope that you will not be fooled by the ads and will vote for the candidates in the elections that you believe will best protect our unique manifestation of democracy now and for future generations. 

 

I would like to forget the offensive ads. I wish I could get over the sense of alienation from many of my neighbors who think differently.  I am sure that I will spend the next four weeks dealing with the fear for our collective future that comes over me when I hear the pundits predict that the control of one or both houses of Congress will change hands. I may be wrong, but I fear that Republican control of the House and maybe the Senate would guarantee no progress for at least the next two years in the effort to improve the social determinants of health for millions of Americans.

 

It is in times like these that I am happy that there are beacons of hope in the struggle for health equity like The Robert Wood Johnson Foundation. If you clicked on the link you were able to read:

 

Since our founding in 1972, RWJF has worked to improve health and healthcare in the United States. We support efforts to build a national Culture of Health rooted in equity that provides every individual with a fair and just opportunity for health and well-being, no matter who they are, where they live, or how much money they have.

 

That statement is laudable and there are many other organizations around the country that could say “Amen” to those sentiments. Recently Richard E. Besser, who is a physician, the President and CEO of the Robert Wood Johnson Foundation, and the former acting director of the CDC, and  Avenel Joseph, Ph.D. who is the Vice President for Policy at the Robert Wood Johnson Foundation have been writing opinion pieces in the online political website, The Hill. In August after the passage of the critical Inflation Reduction Act with Vice President Harris’ tie-breaking vote, Besser and Joseph presented the RWJF position on what had been accomplished and the work that was yet to be done in an opinion piece in The Hill. In the excerpt below I have bolded some of their words. They wrote:

 

…this bill [The Inflation Reduction Act], historic as it is, will only take us so far toward an America in which all people truly have the opportunity for health and wellbeing. Closing the divide between the policies necessary to put health within reach and the political viability of those policies has never been more critical.  

For a nation where policymaking tends to lurch from crisis to crisis and long-term goals are scant, the Inflation Reduction Act is a welcome change. People who receive healthcare coverage through the Affordable Care Act will be protected from potentially debilitating increases in their premium costs over the next three years. Tens of millions of seniors on Medicare will benefit from lower out-of-pocket costs and prescription drug prices, a cap on the price of insulin, and more vaccines available for free; higher subsidies for beneficiaries with low incomes will help those most in need. And with climate change looming as an existential threat and the health and economic effects associated with severe weather events impacting more Americans personally, the new law will help cut high energy costs for consumers in the short term while laying the groundwork for major reductions in greenhouse gas emissions over the next decade.  

Yet even with these provisions becoming law, we must be upfront about what this bill could have been and what still needs to be done. As the nation’s largest health philanthropy, the Robert Wood Johnson Foundation hoped for a far broader and more equitable effort to help create an America in which race, ethnicity, income level, neighborhood, disability, occupation and immigration status no longer determine how long and how well people live. Sadly, this law does not reach that mark, and the barriers to better health and economic opportunity have become more entrenched since the original, more expansive bill was introduced more than a year ago. 

 

I agree with their piece. We should have done better. The Inflation Reduction Act was better than nothing, but the Build Back Better proposal from which it was derived as a feeble remnant would have been a huge leap forward in the effort to improve the social determinants of health. We can do better, but the midterm elections stand as a hurdle to be cleared before there can be any opportunity to do better.  I hope that after the midterm elections there will be at least 52 Democratic senators and that the Democratic Party will still control the House. Why 52 senators? We need 52 to nuetralize Senators Manchin and Sinema. It was Manchin and Sinema who gutted Build Back Better of its many tools to improve the social determinants of health. Ironically, those two did for Republicans what Republicans were temporarily unable to do. Much was lost and many people were deprived of the relief they needed in the transition to the Inflation Reduction Act that Manchin and Sinema would support. It was not even half a loaf, but it was better than nothing. Larger Democratic Congressional majorities would defang Sinema and Manchin and could open the door to policies that will improve the lives and health of millions. 

 

I am repulsed by the negative political ads because if against all reason they lead to Republican control of Congress improvements in healthcare will be put on a multi-year hold and the job of those who care about healthcare improvements will be reduced to attempts to preserve remnants of previous gains as sham investigations of the Justice Department and the president are initiated in retaliation for the January 6 Committee investigations and the FBI’s raid on Mara-Lago. Kevin McCarthy has promised those “Bengazi-like”  investigations if he is the next speaker of the House.

 

You may see it another way, and I hope that I am wrong. What I hope for most is that we all look past the negative ads and review the issues. Inflation is a problem that can be solved while the social determinants of health are improved. What we need is the ability to look past the moment and consider the long-term opportunities and risks. If a majority of Americans can take the long view, hope is possible even in the face of gerrymandering and all the mud-slinging ads. 

 

Suddenly It’s Fall

 

If you read last week’s letter you know that my wife and I spent most of the last week of September in Bristol, Rhode Island, and Block Island. It still looked like summer on Block Island and even though the temps were mainly in the sixties, we enjoyed moments when the temperature rose into the seventies. One night the mercury fell into the high fifties. We were surprised by our good fortune. Our major apprehension about the trip had been the weather. It would have been a bummer if what we had experienced was overcast skies, rain, and a chilly breeze. 

 

We got home after dark last Thursday and the first thing we noticed was that it was chilly. At night the temp has been as low as thirty-five. It has been overcast most days, and there have been some intermittent showers, but what was most notable when the sun came up last Friday was that fall had arrived while we were away. We were not at “peak color,” but there was a lot of color to see. The swamp maples around the lake were particularly obvious, and beautiful. Today’s header was taken late in the afternoon on a cloudy day, but you can see the red I am talking about in some of the trees along the shoreline of “Stanley Point” which is one of two “protrusions” into the lake and like much of the lake’s shoreline is permanently protected from development by the Ausbon Sargent Land Trust. The Little Sunapee Protective Association has a FaceBook page with many pictures if you would like to check it out. In our little town, there are many folks who want to pass on to future generations the beauty that has drawn us to this place. 

 

Yesterday was a warm almost cloudless sunny day and my son captured a very fall-ish shot of the color on Colby Point, the big glacial peninsula that almost bifurcates our lake.

 

 

Despite the pictures I have shared with you, I hate to say it but the prognosis for this year’s fall colors is only so, so. It seems that global warming is pushing “peak color” back further into October. The New York Times published an article this week by Debra Kamin entitled “How to Time Your Leaf-Peeping Trip This Fall.” She writes:

 

Months of record-breaking drought in the Northeast have deprived trees of water, and in the West, nearly 100 large fires have swept a path of destruction across seven states.

From California to Oklahoma to Maine, the symphony of colors that accompanies the arrival of a snap in the air is playing out differently in 2022…

 

It seems that once again the culprit is “global warming” which has pushed the color change back several weeks and made the period of peak color shorter. Another sad truth is that the colors won’t be as bright.  In dry warmer weather, the leaves are more likely to go from green to brown and virtually bypass the reds, yellows, and oranges that we want to see. She quotes a biologist:

 

Leaf peepers in the Northeast who may have been hoping that the late summer rains in that region would salvage their season will be disappointed…because it came too late to undo the damage of a dry midsummer.

 

She goes on to say that there are strategies that can maximize the joys of leaf peepers. Her strategy is not going to help me.  She advises traveling to the Olympic Peninsula, the eastern slope of the Rockies, or the upper Midwest, Tennesse, and Kentucky where there was plenty of rain all summer if you really want to see some beautiful fall color. For those of us in the Northeast, we probably will just have to deal with muted colors, that come later, and turn brown sooner while we hope that next year will be better. For those of us facing disappointment in New England she does suggest some online resources: 

 

Travelers in New England can consult the New England Fall Foliage 2022 Forecast, produced by New England Today, and travelers with smartphones can download the Gaia GPS app, created by Outside Online, to check live satellite images of foliage and time their visits accordingly.

 

The summer seemed to pass so fast.  We did not have a baby loon this year, and now I must prepare for a suboptimal display of fall color while I nervously await the outcome of the midterm elections a month from now. I am grateful for all the visits we had this summer. It was great to have a steady flow of family and friends, but I did not sail or fish as much as I had hoped that I would. I am doing the best that I can to get in a few last days of swimming, sailing, and fishing, but the overcast skies, a falling water temperature, and chilly winds have let me know that my next opportunity for those pleasures will be sometime next spring. In the meantime, I will need to be content with watching suboptimal fall colors emerge while I hope the experts are wrong about both the leaves and the election. I think Richards and Jagger, the philosophers who are the heart of the Rolling Stones, had it right when they sang back in 1969:

 

Ah, you can’t always get what you want, no, no, baby

You can’t always get what you want, you can’t now, now

You can’t always get what you want

But if you try sometimes you just might find

You just might find that you

You get what you need, oh yeah

Ah yeah, do that

 

We have to remain hopeful and keep trying. Most years, I like to go up to the top of one of our nearby mountains and take in a huge view. My strategy for this year will be to be on the lookout for individual trees that somehow have overcome the adverse conditions and are resplendent in their color. I have already seen many of these exceptional trees. I would suggest that if you want to optimize your fall experience and can’t get to the eastern slope of the Rockies or make it all the way out to the Olympic Peninsula that you take a walk in your neighborhood this weekend looking for those few trees that are bucking the trend toward brown. I am sure that you will find one, and that will be all that you need. 

Be well,

Gene